Rural doctor shortage prompts opening of medical school

KANSAS CITY, Kan | By Kevin Murphy

KANSAS CITY, Kan (Reuters) - A Kansas college hopes young doctors will be more willing to practice in small towns if they go to a medical school in a rural area.

The University of Kansas will have what it says is the smallest four-year medical education site in the country when eight students begin taking classes on Monday on a satellite campus in Salina, Kansas. The move is in response to a shortage of rural doctors in the United States.

"By training physicians in a nonmetropolitan area, we are showing young medical students that life can be good, and practice can be stimulating, outside of the big city," said Dr. William Cathcart-Rake, the physician who directs the University of Kansas School of Medicine-Salina.

Students will get some course work via tele-video and podcasts from the school's other campuses, but they will also train through visits to doctors' offices in small communities and at the hospital in Salina, school officials said.

"It's a bold and innovative move," said Dr. Roland Goertz, president of the American Academy of Family Physicians. He said students at rural clinics will be exposed to a potential medical career they wouldn't see in urban hospital settings.

Cathcart-Rake said six of the eight students being taught at Salina, as part of their scholarships, have committed to practicing in a rural area. Seven of the eight students are from rural areas to begin with, he said.

"They see the value of living in wide open spaces and going back to where their friends are," Cathcart-Rake said. Attending medical school in a place such as Salina reduces chances they will change their minds, which could happen if they went to a big-city school, he said.

Salina, with 46,000 residents, is about 175 miles west of the Kansas City metropolitan region where the university's main medical school is located.

Small-town America has become increasingly under-served by doctors. About 21 percent of U.S. residents live in rural regions but only about 10 percent of physicians practice there, according to data cited by the family physicians group.

In Kansas, 12 counties don't have a full-time doctor at all, said Barbara Atkinson, executive dean of the University of Kansas School of Medicine.

Several factors are often cited for a shortage of rural doctors.

Rural doctors tend to be paid less, partly because they are more likely to treat patients on Medicare and Medicaid, which reimburses at rates below standard insurance. General practitioners make up the largest share of rural doctors, but until recent years fewer medical students were going into general medicine, putting a strain on rural care.

Older doctors who practice in small towns and retire are sometimes not replaced because younger doctors may prefer the greater cultural amenities urban regions tend to offer.

Recent changes in federal healthcare laws are intended to make rural practice more acceptable to doctors. Doctors who practice in certain underserved areas will get bonuses beyond the 10 percent boost in Medicare reimbursements they were already receiving, Goertz said.

He said another reason why there are fewer rural doctors is that the large majority of medical students come from urban areas, where medical schools are usually located, making them less like to consider rural medicine.

"You tend to gravitate to where you grew up," Goertz said.

Cathcart-Rake is optimistic that the Salina medical school will be a success and that in future years admissions may grow from eight to 12 students.

(Editing by Mary Wisniewski and Tim Gaynor)

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